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. 2019 Aug;20(5-6):413-420.
doi: 10.1080/21678421.2019.1612435. Epub 2019 May 26.

Clinical characteristics of a large cohort of US participants enrolled in the National Amyotrophic Lateral Sclerosis (ALS) Registry, 2010-2015

Jaime Raymond  1 , BjÖrn Oskarsson  2 , Paul Mehta  1 , Kevin Horton  1
Affiliations

Clinical characteristics of a large cohort of US participants enrolled in the National Amyotrophic Lateral Sclerosis (ALS) Registry, 2010-2015

Jaime Raymond et al. Amyotroph Lateral Scler Frontotemporal Degener. 2019 Aug.

Abstract

Background: Amyotrophic lateral sclerosis (ALS) is a progressive fatal disease with a varying range of clinical characteristics. Objective: To describe the clinical characteristics in a large cohort of ALS participants enrolled in the National ALS Registry. Methods: Data from ALS participants who completed the Registry's online clinical survey module during 2010-2015 were analyzed to determine characteristics, such as site of onset, associated symptoms, time of symptom onset to diagnosis, time of diagnosis to hospice referral, and pharmacological and non-pharmacological interventions. Results: Of the 1758 participants who completed the survey, 60.9% were male, 62.1% were 50-69 years old, and 95.5% white. Approximately, 72.0% reported initial limb weakness onset of disease, followed by bulbar (22.1%), and trunk/global onset (6.1%). Other symptoms ever experienced included cramps (56.7%), fasciculations (56.3%), and dysarthria (33.0%). The median time between an increase of muscle cramps until an ALS diagnosis was 12 months; limb onset participants had cramps longer preceding diagnosis versus those with bulbar onset. The most frequent interventions used included riluzole (48.3% currently using), wheelchairs/scooters (32.8%), and noninvasive breathing equipment (30.0%). Participants with trunk/global onset were referred to hospice almost four times earlier than others. Conclusions: These data show how ALS clinical characteristics differ widely in a large cohort of participants preceding diagnosis and reflect variations in disease onset, progression, and prognosis. Better characterization of symptom onset may assist clinicians in diagnosing ALS sooner, which could lead to earlier therapeutic interventions.

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Conflict of interest statement

Declaration of interest

The CDC/ATSDR authors have no declarations of interest. Dr. Oskarsson has no declarations of interest linked to the study. He has served as a consultant for Biogen and FlexPharma in 2018 and receives research funding from Cytokinetics, Biogen, Orion, Eisai, and Roche.

Figures

Figure 1.
Figure 1.
Median time from ALS diagnosis to symptoms onset among adults with ALS, 19 October 2010–31 December 2015.
Figure 2.
Figure 2.
Median time from ALS diagnosis to symptoms onset stratified on body part weakness among adults with ALS, 19 October 2010–31 December 2015.
See this image and copyright information in PMC

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